An Insight into Paediatric Anaesthesia Specialist Training in Zambia
EM: What is Paediatric Anaesthesia Specialist Training in Zambia?
EM: Why is it important to have a Specialist Training Program for Paediatric Anaesthesia?
SM: Paediatric patients encompass a huge spectrum of development; we have children who are born prematurely and children who are on the cusp of adulthood. All of them have such different physiological and psychological requirements in addition to differences in their understanding of their illnesses and treatments. A child’s understanding and perception of the peri-operative period can be made more complex by their diverse cultural and socioeconomic backgrounds. It’s important to have a Specialist Training Program to provide anaesthetists with the skills to navigate these challenges. Finally, the Specialist Training Program prepares Fellows to provide safe anaesthetic care in unfamiliar settings. For those children who are unable to reach our Specialist Children’s Hospitals, we go to them, taking surgical teams to their local hospitals as part of outreach missions.
EM: What made you decide to specialise in Paediatric Anaesthesia?
SM: Paediatric anaesthesia is very mentally stimulating and very mentally challenging! There is no “cookie-cutter” approach to delivering an anaesthetic. Every child comes to you with a different set of problems and challenges that you have to overcome. You really have to exercise your mental muscle in order to provide the best standard of care.
SM: I also appreciate that working with paediatric patients naturally develops a physician’s non-clinical skills. You begin to understand subtleties in patient behaviour. You start to refine your approach to different patients in order to take into consideration factors like their physical and mental age and their understanding of their illness. These skills start to spill over into practice with adults. Essentially paediatric anaesthesia has a positive ripple effect on all other aspects of anaesthesia.
SM: Finally, I think this Fellowship is a really exciting collaboration. The program has given me the opportunity to do sub-specialty training in my home country. It means a whole lot to me that through my learning I will be able to positively impact children right here in Zambia.
EM: What is an average day like for a Paediatric Anaesthesia Specialist?
SM: We do occasionally have surgical outreaches to places like Kabwe or Chitokoloki Mission up in the North-Western corner of Zambia. On these missions my days are a bit different. On the first morning of our outreach the surgeons have a clinic then in the afternoon we start with some simpler, short cases. We then plan for the next couple of days of the outreach. Unlike working at UTH, where I usually have a resident or non-physician anaesthetist with me, on missions I’m typically by myself. As a result my focus is on clinical work with less focus on supervision, although this can depend on the staff present at the mission centre. Depending on the surgical caseload we can have 12-14 hour days as we bear in mind that we may have limited opportunity to return.